Back to Search
Start Over
Modified reduced-volume intensity-modulated radiation therapy in non-metastatic nasopharyngeal carcinoma: A prospective observation series
- Source :
- Radiotherapy and Oncology. 156:251-257
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background and purpose Although the efficacy of “reduced-volume intensity-modulated radiation therapy (IMRT)” in nasopharyngeal carcinoma (NPC) has been confirmed, two issues regarding the necessity of clinical target volume 1(CTV1) delineation and the optimal margin of CTV2 remained undetermined. The current series, utilized de-intensification technique that omitted the contouring of CTV1 and narrowed the margin of CTV2 from 10 mm to 8 mm, namely “modified reduced-volume IMRT” was initiated to evaluate the efficacy and feasibility of this renew technique in a prospective series. Patients and materials Dosimetric analysis was performed in 40 non-metastatic NPC cases to evaluate whether our modification is feasible. Then this de-intensification technique was applied in non-metastatic NPC patients treated in our attending group since late 2014. Survival outcomes focused on local recurrence-free survival (LRFS) and local failure pattern were analyzed. Results Preliminary dosimetric evaluation of “modified reduced-volume IMRT” showed that the 60 Gy isodose curve generated naturally by this technique could well wrap the target area of CTV1. Subsequent observation series, which included a total of 471 patients and had a median follow-up time of 46.2 months(range,3.7–70.8 months), reported that 4-year estimated LRFS, regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were 96.6%, 97.7%, 87.7% and 92.4%, respectively. All local recurrence lesions occurred within 95% isodose lines and were considered in-field failures. Conclusions Our de-intensification technique “modified reduced-volume IMRT” was feasible and did not compromise therapeutic efficacy, well-designed multicenter prospective trials are needed for further research.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Planning target volume
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Non metastatic
Radiology, Nuclear Medicine and imaging
Prospective Studies
Neoplasm Staging
Series (stratigraphy)
Contouring
Nasopharyngeal Carcinoma
business.industry
Local failure
Nasopharyngeal Neoplasms
Hematology
Intensity-modulated radiation therapy
medicine.disease
Radiation therapy
Oncology
Nasopharyngeal carcinoma
030220 oncology & carcinogenesis
Radiotherapy, Intensity-Modulated
Radiology
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 01678140
- Volume :
- 156
- Database :
- OpenAIRE
- Journal :
- Radiotherapy and Oncology
- Accession number :
- edsair.doi.dedup.....e006af05ba2a257f74b7cd0fd20ce124